Catatonia Associated with Buprenorphine-Induced Toxic Leukoencephalopathy

It is well-known that West Virginia (WV) is one of the states most affected by the opioid epidemic. Recently, WV has implemented a program to expand buprenorphine use as part of a multi-prong approach to treat opioid use disorder accompanied by positive outcomes. However, buprenorphine can be diverted and obtained outside of a medical provider's guidance. Given the prevalence of buprenorphine use in WV, we aim to present original clinical data prompting clinicians to recognize buprenorphine as a potential cause of toxic leukoencephalopathy. We describe the case of a 28-year-old female who presented with catatonia believed to be secondary to buprenorphine, and we discuss the diagnostic challenges and therapeutic management of buprenorphine-induced toxic leukoencephalopathy.